title: Treatment of the obese patient in primary care: targeting and meeting goals and expectations.
abstract: Obesity is a serious disease associated with increased patient risk of several comorbidities, including type 2 diabetes mellitus, cardiovascular disease, dyslipidemia, hypertension, some cancers, and greater mortality. Furthermore, obesity has a deleterious impact on quality of life and increases health care costs. Moderate weight loss of 5% to 10% has been shown to significantly improve several patient cardiometabolic risk factors and physical functioning, however, it is often difficult to begin the weight-loss conversation with patients. Primary care providers play a critical role in discussing the health effects of excess weight with patients, managing obesity-related comorbidities, and recommending appropriate weight-loss strategies. Open communication, realistic goal setting, and consistent monitoring are key factors in implementing an effective weight-loss program in the primary care setting. Although diet and lifestyle modifications are the first lines of approach and the foundation of any weight-loss strategy, in many cases, additional interventions may be necessary, including medical or surgical management. Herein, we discuss the approaches that primary care providers should consider when recommending appropriate weight-loss strategies for overweight/obese patients to achieve clinically meaningful weight loss, including pharmacotherapies approved for chronic management of patients with obesity, to be used as adjuncts to diet and lifestyle modifications, and surgical options.
authors.affiliation: Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA. George.Bray@pbrc.edu.
authors.forename: George
authors.initials: G
authors.lastname: Bray
authors.forename: Michelle
authors.initials: M
authors.lastname: Look
authors.forename: Donna
authors.initials: D
authors.lastname: Ryan
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use; D050110:Bariatric Surgery; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D050171:Dyslipidemias / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D009369:Neoplasms / Q000209:etiology / Q000628:therapy; D009765:Obesity / Q000150:complications / Q000628:therapy*; D011320:Primary Health Care / Q000379:methods*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D061217:Weight Reduction Programs / Q000379:methods*
chemical_list: D019440:Anti-Obesity Agents; D007004:Hypoglycemic Agents